Perception of anxiety as a contributing factor of asthma: indigent versus nonindigent

Although asthma is not an emotional or psychological disease, strong emotions can sometimes make asthma worse. Asthmatic attacks and reductions in FEV1 have been intentionally induced in asthmatic patients through exposure to emotional stimuli. People of lower socioeconomic status have been associated with higher prevalences of both anxiety and depression. Therefore, a group of indigent (IP) and nonindigent privately insured asthmatic patients (non-IP) were surveyed to determine their perceptions of asthma triggers. The patients responded to several possible triggers by the following descriptors: never, rarely, sometimes, frequently, always. There were no significant differences at the 0.05 level between the groups in age, gender, or length of history of asthma. In response to the question pertaining to asthma triggered when upset or anxious, 51% of 57 patients responded to the "frequently" or "always" category in the IP compared to 19% of 52 in the non-IP. Further research is warranted to explain these differences. If these differences are real, optimal therapies for psychogenic asthma (e.g., addition of anticholinergic aerosols) or the treatment of anxiety itself in the IP need to be evaluated.